Do Blood Pressure Medications Cause Memory Loss?

Is The Cure Worse Than The Disease?

Author: Dr. Stephen Chaney

High blood pressure has been called a silent killer. This is because it is possible to go for years with high blood pressure and not even know it. Even worse, the consequences of untreated high blood pressure can be catastrophic – stroke, heart attack, congestive heart failure, kidney failure – the list goes on and on. But, what about when high blood pressure is treated? Do blood pressure medications cause memory loss?

Because of that, the standard medical recommendation for years has been to:

Have your blood pressure tested frequently (at least once a year if your blood pressure is in the normal range and more frequently if it is elevated).

If your blood pressure is elevated, get on a blood pressure medication and try to keep your blood pressure as close to normal as possible.

But, is this always the best advice? Maybe not, particularly when we consider the confusing effects of blood pressure on cognitive function.

We have known for years that untreated high blood pressure in middle aged individuals significantly increases the probability that they will suffer cognitive decline in their later years (for example, R. F. Gottesman et al, JAMA Neurology, 71: 1218-1227, 2014).

Conversely, when we look at the elderly as a group we find that those with the lowest blood pressure actually have a higher risk of cognitive decline than those with the highest blood pressure (for example, B. Sabayan et al, Journal of the American Geriatric Society, 60: 2014-2019, 2012).

How can we reconcile such conflicting data on the correlation between blood pressure and cognitive decline in the elderly? Could it possibly be that it was the blood pressure drugs rather than blood pressure itself that was causing cognitive decline in the elderly?

Do Blood Pressure Medications Cause Memory Loss?

A group of scientists in Italy set up a clinical study to determine whether blood pressure or use of blood pressure drugs better correlated with cognitive decline in elderly patients who already have some degree of cognitive impairment (E. Mossello et al, JAMA Internal Medicine, doi: 10.1001/jamainternmed.2014.8164).

They enrolled 172 patients from 2 outpatient memory clinics in the study. The average age of the participants was 79 and all of them had some degree of cognitive impairment (68% with dementia and 32% with mild cognitive impairment). 70% of the study participants were on blood pressure drugs. Their blood pressure was measured on a daily basis, and they were tested for cognitive function at the beginning of the study and 9 months later.

The results of the study concerning:

Those with the lowest blood pressure had the highest rate of cognitive decline over the 9 month period. These results were similar to several previous clinical trials with the elderly.

The association between low blood pressure and cognitive decline was only seen in those subjects on blood pressure medications. Low blood pressure did not increase the risk of cognitive decline in unmedicated subjects.

There are, of course, some significant limitations to this study:

It is a small study of short duration.

It is the first study of its kind. It needs to be repeated.

It was done in an elderly population who already suffered from cognitive decline. We don’t yet know to what extent these conclusions will apply to younger people and to people without cognitive impairment.

Is The Cure Worse Than The Disease?

However, this study does raise a huge red flag that needs to be evaluated very carefully. It raises the issue of whether aggressive drug treatment to bring blood pressure under control may, under some conditions, cause more problems than it cures. It is not unlike the study a few years ago showing that aggressive treatment to lower blood sugar levels in type 2 diabetics actually increased the death rate (C. J. Currie et al, The Lancet, 375: 481-489, 2010).

It turns out that increased risk of cognitive decline is just one of several risks associated with aggressive drug treatment to lower blood pressure. Because of that realization an expert panel recently recommended that the threshold for the use of blood pressure drugs be raised from 130/90 to 140/90 for adults under 60 and to 150/90 for adults over 60.

Do blood pressure medications cause memory loss? It’s not that high blood pressure has suddenly become healthier. Rather, the experts realized that the risks of aggressive drug treatment to lower moderately elevated blood pressure outweighed the benefits. The cure was worse than the disease!

Is There Another Option?

The answer is a resounding yes, and we have known about it for years. It is called the DASH (Dietary Approaches To Stop Hypertension) diet. It is recommended by the American Heart Association, the National Heart, Lung & Blood Institute, the USDA 2010 Dietary Guidelines for Americans and the US Guidelines for Treatment of High Blood Pressure). Coupled with a few simple lifestyle changes it has been shown to be as effective as drugs at reducing high blood pressure, without the side effects of the drugs.

You can find the details of the DASH diet here (http://dashdiet.org/), but in simple terms, it is low in fat, high in fresh fruits and vegetable, fiber and low fat dairy products. The recommended lifestyle changes are weight control, restricted sodium intake and exercise.

Although not all experts agree, I personally recommend that you also make sure that you are getting the DV for calcium, magnesium and vitamin D from food and supplements and consider supplementing with long chain omega-3 fatty acids and polyphenols – especially resveratrol and related polyphenols from grape skins and seeds.

The Bottom Line

High blood pressure is a silent killer because people often don’t know they have it. If left untreated it can cause stroke, heart attack, congestive heart failure and kidney failure.

However, a recent study suggested that aggressive drug treatment to treat high blood pressure in the elderly can increase the rate of cognitive decline.

Because of this and other risks associated with aggressive drug treatment for high blood pressure, especially in the elderly, an expert panel recently recommended that the threshold for the use of blood pressure drugs be raised from 130/90 to 140/90 for adults under 60 and to 150/90 for adults over 60.

It’s not that high blood pressure has suddenly become healthier. Rather, the experts realized that the risks of aggressive drug treatment to lower moderately elevated blood pressure outweighed the benefits. The cure was worse than the disease!

Fortunately, there is another option, namely the DASH diet. The DASH diet, along with a few simple lifestyle modifications, has been shown to be as effective as drugs at reducing high blood pressure without the side effects of high blood pressure medications. Both the American Heart Association and the National Heart, Lung and Blood Institute recommend that the DASH diet and lifestyle changes be tried first, before considering use of blood pressure medications.

Although not all experts agree, I personally recommend that you also make sure that you are getting the DV for calcium, magnesium and vitamin D from food and supplements and consider supplementing with long chain omega-3 fatty acids and polyphenols – especially resveratrol and related polyphenols from grape skins and seeds.

Finally, high blood pressure is dangerous. Don’t ignore it. Get your blood pressure tested regularly. If it is elevated, talk with your doctor about the best combination of diet, and lifestyle change and whether medications are absolutely necessary to keep your blood pressure under control.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

A Sleeping position that has your head tilted puts pressure on your spinal cord and will cause headaches. I’ve seen it happen hundreds of times, and the reasoning is so logical it’s easy to understand.

Your spinal cord runs from your brain, through each of your vertebrae, down your arms and legs. Nerves pass out of the vertebrae and go to every cell in your body, including each of your organs. When you are sleeping it is important to keep your head, neck, and spine in a horizontal plane so you aren’t straining the muscles that insert into your vertebrae.

The graphic above is a close-up of your skull and the cervical (neck) vertebrae. Your nerves are shown in yellow, and your artery is shown in red. Consider what happens if you hold your head to one side for hours. You can notice that the nerves and artery will likely be press upon. Also, since your spinal cord comes down the inside of the vertebrae, it will also be impinged.

In 2004 the Archives of Internal Medicine published an article stating that 1 out of 13 people have morning headaches. It’s interesting to note that the article never mentions the spinal cord being impinged by the vertebrae. That’s a major oversight!

Muscles merge into tendons, and the tendons insert into the bone. As you stayed in the tilted position for hours, the muscles actually shortened to the new length. Then you try to turn over, but the short muscles are holding your cervical vertebrae tightly, and they can’t lengthen.

The weight of your head pulls on the vertebrae, putting even more pressure on your spinal cord and nerves. Plus, the tight muscles are pulling on the bones, causing pain on the bone.

Your Pillow is Involved in Your Sleeping Position and the Causes of Headaches

The analogy I always use is; just as pulling your hair hurts your scalp, the muscle pulling on the tendons hurts the bone where it inserts. In this case it is your neck muscles putting a strain on your cervical bones. For example, if you sleep on your left side and your pillow is too thick, your head will be tilted up toward the ceiling. This position tightens the muscles on the right side of your neck.

Dozing off while sitting in a car waiting for someone to arrive, or while working for hours at your desk can also cause headaches. The pictures above show a strain on the neck when you fall asleep without any support on your neck. Both of these people will wake up with a headache, and with stiffness in their neck.

The best sleeping position to prevent headaches is to have your pillow adjusted so your head, neck, and spine are in a horizontal line. Play with your pillows, putting two thin pillows into one case if necessary. If your pillow is too thick try to open up a corner and pull out some of the stuffing.

Sleeping on Your Back & Stomach

If you sleep on your back and have your head on the mattress, your spine is straight. All you need is a little neck pillow for support, and a pillow under your knees.

Stomach sleeping is the worst sleeping position for not only headaches, but so many other aches and pains. It’s a tough habit to break, but it can be done. This sleeping position deserves its own blog, which I will do in the future.

Treating the Muscles That Cause Headaches

All of the muscles that originate or insert into your cervical vertebrae, and many that insert into your shoulder and upper back, need to be treated. The treatments are all taught in Treat Yourself to Pain Free Living, in the neck and shoulder chapters. Here is one treatment that will help you get relief.

Take either a tennis ball or the Perfect Ball (which really is Perfect because it has a solid center and soft outside) and press into your shoulder as shown. You are treating a muscle called Levator Scapulae which pulls your cervical vertebrae out of alignment when it is tight.

Hold the press for about 30 seconds, release, and then press again.

Your pillow is a key to neck pain and headaches caused by your sleeping position. It’s worth the time and energy to investigate how you sleep and correct your pillow. I believe this blog will help you find the solution and will insure you have restful sleep each night.

Wishing you well,

Julie Donnelly

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Meet The Experts

The statements in these articles have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease. Any Health Care changes should be made only after consulting with your Doctor and licensed Health Care Advisor.

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